Prediction of Cerebral Venous Thrombosis with a new clinical score and D-dimer levels

OBJECTIVE:To investigate prediction of cerebral venous thrombosis (CVT) by clinical variables and D-dimer levels.

METHODS:This prospective multicentre study included consecutive patients with clinically possible CVT. On admission, patients underwent clinical examination, blood-sampling for D-dimers-measuring (ELISA-test), and MR-/CT-venography. Predictive value of clinical variables and D-dimers for CVT were calculated. A clinical score to stratify patients into groups with low, moderate, or high CVT risk was established using multivariate logistic regression.

RESULTS:CVT was confirmed in 25.8% (94/359) patients by neuroimaging. The optimal estimate of clinical probability was based on 6 variables: seizure(s) at presentation (4 points), known thrombophilia (4 points), oral contraception (2 points), duration of symptoms >6 days (2 points), worst headache ever (1 point) and focal neurological deficit at presentation (1 point) (AUC 0.889). We defined 0-2 points as low CVT probabi...

研究目的：探讨基于临床变量与D-二聚体（D-dimer）水平预测脑静脉血栓形成（cerebral venous thrombosis, CVT）的临床价值。
方法：本研究为前瞻性多中心研究，纳入临床疑似脑静脉血栓形成的连续性患者。患者入院时接受临床体格检查、采血以检测D-二聚体水平（酶联免疫吸附试验，ELISA），并完成磁共振静脉造影/计算机断层静脉造影（MR-/CT-venography）检查。计算临床变量与D-二聚体对脑静脉血栓形成的预测效能。采用多因素logistic回归分析，构建可将患者划分为低、中、高脑静脉血栓形成风险组的临床评分模型。
结果：经神经影像学检查确诊为脑静脉血栓形成的患者占比为25.8%（94/359）。临床概率的最优预测模型共纳入6项评估指标：就诊时伴癫痫发作（4分）、已知血栓形成倾向（4分）、口服避孕药（2分）、症状持续时长＞6天（2分）、就诊时出现毕生最剧烈头痛（1分），以及就诊时伴局灶性神经功能缺损（1分）（曲线下面积AUC 0.889）。本研究将0~2分定义为低脑静脉血栓形成概率……